Abstract
Sixteen kidney transplant recipients received the IgG2a anti-CD3 monoclonal antibody OKT3 and azathioprine as rejection prophylaxis during the first two postoperative weeks. Concomitant immunosuppression consisted of low dose steroids while cyclosporine A therapy was instituted on day 12. Side effects included fever, bronchospasm, hypotension and diarrhoea. OKT3 caused T cell modulation resulting in CD3 dim+, CD4+ or CD8+, CD5+, WT31- and 11F2- cells. Anti-OKT3 antibodies were found in approximately 50% of the patients. The protocol induced a 100% patient and graft survival and a 81% actuarial freedom of rejection at 18 months. It prevented CsA associated nephrotoxicity in the direct postoperative phase. These beneficial effects outweighed the side effects of OKT3.
MeSH terms
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Adult
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Aged
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Antibodies / immunology
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / immunology
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Antibodies, Monoclonal / therapeutic use*
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Antigens, Differentiation / immunology
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Antigens, Differentiation, T-Lymphocyte / immunology
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CD3 Complex
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CD5 Antigens
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Cyclosporins / administration & dosage
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Cyclosporins / therapeutic use*
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Drug Administration Schedule
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Feasibility Studies
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Female
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Graft Rejection / drug effects*
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Humans
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Immunoglobulin M / immunology
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Kidney Transplantation / immunology*
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Male
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Middle Aged
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Receptors, Antigen, T-Cell / immunology
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T-Lymphocyte Subsets / immunology
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T-Lymphocytes / immunology
Substances
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Antibodies
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Antibodies, Monoclonal
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Antigens, Differentiation
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Antigens, Differentiation, T-Lymphocyte
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CD3 Complex
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CD5 Antigens
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Cyclosporins
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Immunoglobulin M
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Receptors, Antigen, T-Cell